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Opioid misuse represents a major public health issue in the United States. One driver is overprescription for acute pain, with the size of initial prescription associated with subsequent long-term use. However, little work has been done to elicit clinician feedback about interventions to reduce opioid prescribing. To address this knowledge gap, qualitative analyses were conducted with clinicians who participated in a randomized controlled trial in which clinicians received monthly emailed feedback notifications about their opioid prescribing behaviors. Semistructured telephone interviews were conducted (N = 12) with urgent care (N = 7) and emergency department (N = 5) clinicians who participated in the trial between November 2020 and April 2021. Clinicians appreciated feedback about their prescribing behavior and found comparative data with peer clinicians to be most useful. Sharing opioid prescribing feedback data with clinicians can be an acceptable way to address opioid prescribing among emergency and urgent care clinicians. [ABSTRACT FROM AUTHOR]

The author ponders on the application of the positive deviance (PD) approach to identify and learn from those who have consistently done exceptional performance in the field of health care and public health. He defines PD as a quality improvement (QI) strategy and framework that can be used to evaluate health care organizations, community health programs and health intervention planning. The author notes that PD is a relevant QI method that can help the public health sector.

Pandemic influenza is an imminent threat, with the April/May 2009 A(H1N1) outbreak as a testament to the potential for rapid transmission and spread of a novel influenza strain. Research has shown that there are great disparities in state pandemic planning; however, little work has been done to assess how health department structure impacts pandemic preparedness. The purpose of this article was to examine the impact of state health department structure on state pandemic influenza plan integration of federal recommendations. The study consisted of a cross-sectional analysis of 41 states and found that structural and strategy-making variables have the greatest impact on pandemic plan inclusion of federal recommendations. Strong, multilayered health department hierarchies and the tenure of senior staff are negatively associated with preparedness, whereas professionalization is positively associated with pandemic plan comprehensiveness. State health departments can take minimally invasive steps to increase their effectiveness in pandemic preparedness by reducing layers of bureaucracy and increasing training for staff.